Hemodynamic changes effect on mitral valve area in stenosed mitral valve

ABSTRACT

dobutamine stress echocardiography is a good tool in assessment of valvular heart disease but it is still underused in MS so this work aimed at detection if MVA can change with changing hemodynamics or not still subject of cutovers. dobutamine stress echo was done for 30 patients with isolated MS in sinus rhythm, MVA measured by both Planimetry and PHT methods at rest and after dobutamine infusion. Result: COP increased by > 50% in 13 patients [group I] and by <50% in 17 patients [group II] MVA by Planimetry increased by [27.3 +/- 10.23%] in group I and by [17 +/- 17.71%] in group II [NS difference] but as regards MVA by PHT shows increase by [43 +/- 29.57%] in group I and by [17.2 +/- 28.7%] in group II significant difference [p < 0.05], with increase in cardiac output important clinical changes [from sever to moderate] in 7 patients by Planimetry and in 5 patients by PHT and from [sever to mild] in 2 patients by PHT. MVA is dynamic and responds to increase in COP inspite these changes are small but clinically significant. Also both Planimetry and PHT are accurate methods in assessing MVA with changing hemodynamics and stress echo is safe and productive technique in MS